Neuroendocrine tumour grade (Ki-67) and WHO classification
How fast the tumour cells are dividing, measured by Ki-67 staining, separates slow-growing neuroendocrine tumours from aggressive neuroendocrine carcinomas and decides the treatment.
Overview
WHO 2019/2022: well-differentiated NET grade 1 (Ki-67 <3%), grade 2 (3-20%), grade 3 (>20%, well-differentiated); poorly differentiated neuroendocrine carcinoma (NEC, small- or large-cell) is a separate lineage treated like small-cell lung cancer. Grade drives choice among somatostatin analogues, PRRT, targeted therapy and chemotherapy.
- Pancreatic head (most PDAC)
- Body and tail
- Ampulla
- Islets (pancreatic NET)
- Intrahepatic ducts
- Perihilar (Klatskin)
- Distal bile duct
- Gallbladder
- Nodes: peripancreatic
- Nodes: hepatic hilar
- Nodes: coeliac and superior mesenteric
Most pancreatic indications arise in the head next to the bile duct, which is why jaundice is the presenting sign; bile duct indications are named by where along the tree they sit.
- Pancreatic head (most PDAC)
- Body and tail
- Ampulla
- Islets (pancreatic NET)Small-bowel (midgut) NET, often with carcinoid syndrome · Pancreatic NET (functioning: insulinoma, gastrinoma, glucagonoma; non-functioning) · Lung NET (typical and atypical carcinoid) · Grade 3 well-differentiated NET · Neuroendocrine carcinoma (small- and large-cell), treated like SCLC
- Intrahepatic ducts
- Perihilar (Klatskin)
- Distal bile duct
- Gallbladder
- peripancreatic
- hepatic hilar
- coeliac and superior mesenteric
Same organ: Pancreatic neuroendocrine tumours, Grade 3 well-differentiated neuroendocrine tumour
Showing the organ this term concerns: Neuroendocrine tumours.
Similar pages
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